NPIMap

Individual provider Active NPI

Paul Peterson, CRNA

  • Certified Registered Nurse Anesthetist
  • Overland Park, KS
National Provider Identifier
1861448524
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
54581 Issued in KS
Practice address
12300 Metcalf Ave
Anesthesia Dept
Overland Park, KS 66213-1324
Phone
(816) 389-6030
Fax
(816) 389-6034
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 54581 KS Primary
Certified Registered Nurse Anesthetist 367500000X 093647 MO

Addresses

Primary practice location

12300 Metcalf Ave
Anesthesia Dept
Overland Park, KS 66213-1324

Mailing address

9233 Ward Pkwy
Suite 230
Kansas City, MO 64114-3366
Phone (816) 389-6030

Other identifiers 1

IdentifierTypeStateIssuer
19059024OtherKSBCBS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070327000605 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123045663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2305 S Hwy 65
Marshall, MO 65340-3702
Phone (660) 886-7800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54581KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
John Fitzgibbon Memorial Hospital Inc. CurrentSince Jan 1, 2011 Accepting new patients
John Fitzgibbon Memorial Hospital Inc Current Accepting new patients
John Fitzgibbon Memorial Hospital Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2011 Accepting new patients
Anesthesia Services of Eastern Jackson County, P.C. Past Accepting new patients
Mid-Missouri Anesthesiologists, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Truman Medical Centers, Inc. Past Accepting new patients
Consultants in Gastroenterology, PC PastSince Jul 11, 2011 Accepting new patients
Westport Anesthesia Services of Kansas PA Past Accepting new patients
Freeman Neosho Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Excel Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Hannibal Regional Healthcare System Inc Past Accepting new patients
Westport Anesthesia Services of Missouri, PC Past Accepting new patients

Locations

2305 S Highway 65
Marshall, MO 65340
Phone (660) 831-3730

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1861448524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9233 WARD PKWY",
            "address_2": "SUITE 230",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641143366",
            "telephone_number": "816-389-6030",
            "fax_number": "816-389-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 METCALF AVE",
            "address_2": "ANESTHESIA DEPT",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "816-389-6030",
            "fax_number": "816-389-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "PAUL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "54581",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "093647",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "19059024",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.